Epidemics and pandemics

The World Health Organization(WHO) for two months delayed labeling the Ebola outbreak a global emergency for fear of damaging the economy of Guinea and neighboring countries, according to leaked documents and memos from the organization. Beginning in April 2014, WHO’s specialists, both in the field and at the organization’s headquarters in Geneva, were raising an alarm about the spreading epidemic — but it was not until June 2014 that WHO begun seriously to consider the scope of the outbreak, and it was not until August 2014 that WHO defined the Ebola outbreak as an epidemic and declared an international emergency.

The current outbreak of the plague in Madagascar shines a light on the need for new approaches to treat the ancient pathogen. A new UNC study unexpectedly unravels a long-held theory on how a fleabite leads to infection. For decades, scientists have thought the bacteria that cause the bubonic plague hijack host cells at the site of a fleabite and are then taken to the lymph nodes, where the bacteria multiply and trigger severe disease. Researchers discovered, however, that this accepted theory is off base. The bacteria do not use host cells; they traffic to lymph nodes on their own and not in great numbers.

Researchers are using the new Biosurveillance Gateway Web site to map epidemics in order better to understand and prevent deadly diseases. The Web site relies on lab databases and tools from around the world, so that registered health officials and researchers can track outbreaks better to predict how a pathogen might spread in the United States and elsewhere. Though still in its beta state, the Web site provides spread information and mapping on a variety of diseases, including ones that only infect animals or plants. Theoretical computational software is integrated into the maps to help predict what a future epidemic might do, and the histories of recorded outbreaks across the globe are presented for comparison.

New research that focuses on the mechanism by which Ebola virus infects a cell and the discovery of a promising drug therapy candidate. A small molecule called Tetrandrine derived from an Asian herb has shown to be a potent small molecule inhibiting infection of human white blood cells in vitro or petri dish experiments and prevented Ebola virus disease in mice.

In October 2014, during the peak of the Ebola epidemic which terrorized citizens in Liberia, Guinea, and Sierra Leone, security and terrorism analysts considered the probability of the Islamic State (ISIS) or other terror groups weaponizing Ebola and unleashing the virus in New York, Paris, London, or another major city. Many bioweapon researchers played down Martinez’s claim, saying terrorists looking to use Ebola as a weapon would encounter problems. Still, last fall, a U.K. military research unit was tasked with evaluating whether terrorist organizations could use Ebola to attack Western targets.

Scientists are warning that decades of public research on the sequencing of virus DNA are now posing unforeseen threats, as synthesis technologies advance to the point where individuals without expert knowledge may be able to reconstruct long dormant viruses using readily available maps. Diseases which have been extinct for many years may be resurrected by bioterrorists using mail-order DNA kits, with openly published sequence data as their guide. Among these, smallpox eradicated since 1980, could be reintroduced by using the 1994 gene mapping which was prepared in order better to understand why the disease was so deadly.

Sierra Leone’s national auditor has reported that roughly $5.7 million in internal emergency funds allocated to fight the Ebola epidemic had incomplete or no supporting documentation. Poor record keeping and potential misallocation of funds ultimately led to “a reduction in the quality of service delivery in the health sector,” according to the report, which was presented to Parliament last Friday. That amount represents more than a quarter of the $19 million the government spent on Ebola-related activities between May and October 2014.

State lawmakers in California introduced legislation Wednesday that would require children to be fully vaccinated before going to school, a response to a measles outbreak that started in Southern California and has reached 107 cases in fourteen states. California is one of nineteen states that allow parents to enroll their children in school unvaccinated through a “personal belief exemption” to public health laws. The outbreak of measles that began in December in Anaheim’s Disneyland amusement park has spread more quickly in communities where many parents claim the exemption.

A new online resource is providing a centralized portal for all news, information, resources, and research related to biosurveillance at the laboratory. Los Alamos Lab science team gathers a virtual biological toolkit for international disease outbreak response.

The World Health Organization(WHO) has reported fewer than 100 new cases of Ebola in West Africa in the last week, which means the outbreak could soon reach its end. Some of the resources allocated to building treatment centers for thousands of sick people are now being diverted to contact-tracing efforts. “Efforts have moved from rapidly building infrastructure to ensuring that capacity for case finding, case management, safe burials and community engagement is used as effectively as possible,” read the WHO’s latest situation report.

Ever since its discovery, it has been appreciated that Ebola poses a serious risk to global public health. Infectious diseases represent a global threat, not just to those within the country or region of emergence. With the current increase in the movement of people (rural to urban, within countries and across borders), this risk will inevitably increase. While the current priority should be to contain the present outbreak, there is a great need to plan for prevention of future events. The development of an international response group tasked with immediate assessment of and initial response to emerging pathogens is needed, backed by sufficient international political will, clinical expertise, and funding. This needs to be agile and responsive, with clear chains of command, and able to engage early.

Researchers at the University of California, Davis, will explore ways to speed production of the Ebola drug Zmapp with a $200,000 rapid-response grant from the National Science Foundation. Zmapp is a cocktail of antibodies produced in and extracted from whole tobacco plants. The UC Davis team, including plant scientists, molecular biologists and chemical engineers, will attempt to produce the antibodies from plant cells grown in bioreactors instead of in whole plants.

With the Ebola epidemic still a threat, many in the international disease research community are searching for a cure. One such laboratory is a high-security facility in Geelong, Australia. It focuses exclusively on Ebola research and testing, particularly the Zaire strain of the virus, which has ravaged Guinea, Liberia, and Sierra Leone.

Researchers criticize reforms advocated by the International Monetary Fund (IMF) for chronically under-funded and insufficiently staffed health systems in Guinea, Liberia, and Sierra Leone. They say these policies contributed to “lack of preparedness” of West African health systems to cope with disease and emergencies such as Ebola. The researchers argue that IMF programs over the years have imposed heavy constraints on the development of effective health systems of Guinea, Liberia, and Sierra Leone — the cradle of the Ebola outbreak that has killed more than 6,800 since March this year.

2014 has been a trying year for U.S. health officials. Globalization and the movement of people from previously remote villages to large cities introduced diseases such as Ebola to places where the flu virus was once considered the most alarming public health scare. “If anyone still needed convincing, 2014 really showed that a disease threat anywhere is a disease threat everywhere,” said Dr. Tom Frieden, CDC director. A series of mishaps in handling deadly pathogens in CDC and NIH labs raised questions about the safety culture in U.S. biolabs.